Individual provider Active NPI

Rebeca Gonzalez, PA

  • Physician Assistant
  • San Antonio, TX
National Provider Identifier
1235878414
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA16609 Issued in TX
Practice address
590 N General McMullen Dr Ste 1
San Antonio, TX 78228-6299
Phone
(210) 249-0212
Fax
(210) 249-0217
NPI assigned
Jun 3, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X PA16609 TX Primary

Addresses

Primary practice location

590 N General McMullen Dr Ste 1
San Antonio, TX 78228-6299

Mailing address

2961 Mossrock
San Antonio, TX 78230-5119
Phone (210) 731-4800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230413002583 TX Practitioner - Physician Assistant 7214302744 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physician Primecare, IncGroup PAC ID 8628073236, 70 clinicians

Practice addresses (Care Compare)

1910 S New Braunfels
San Antonio, TX 78210-5220
Phone (210) 532-0891

530 San Pedro Ave
San Antonio, TX 78212-5006
Phone (210) 225-4511

810 S E Military Dr
Physician Primecare Val Verde
San Antonio, TX 78214-2823
Phone (210) 921-4200

911 Castroville Rd
San Antonio, TX 78237-3146
Phone (210) 436-7402

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA16609TXMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: rebeca.gonzalez@htmg.eclinicaldirectplus.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1654214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1235878414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2961 MOSSROCK",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782305119",
            "telephone_number": "210-731-4800",
            "fax_number": "210-731-4810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 N GENERAL MCMULLEN DR STE 1",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782286299",
            "telephone_number": "210-249-0212",
            "fax_number": "210-249-0217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "REBECA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-03",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA16609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.